High Blood Pressure and Kidney Disease: How African-Americans Are Especially Vulnerable

This February, in recognition of Heart Month and Black History Month, the American Kidney Fund and the Association of Black Cardiologists (ABC) bring you this important information on the link between high blood pressure and kidney disease in African-Americans.

Hypertension and Kidney Disease

More than 72 million people in the United States have high blood pressure (also called hypertension), which means that your heart is working harder to pump your blood through tubes called arteries and veins. When blood pressure is too high it can harm your body, leading to other health problems such as stroke, heart attack, chronic kidney disease or even kidney failure.

Hypertension is the second-leading cause of kidney failure. When it goes unmanaged, it can damage the tiny filters in your kidneys. This can lead to lasting damage to the kidneys that can get worse over time, called chronic kidney disease (CKD). If the damage is very bad, your kidneys may stop working altogether, causing kidney failure. This means you will need dialysis or a kidney transplant in order to live.

African-Americans’ Increased Risk

African-Americans are at increased risk for both hypertension and kidney disease. They tend to develop hypertension at younger ages and are more likely to develop hypertension-related complications, including kidney failure. In fact, more than 1 in 3 kidney failure patients living in the United States is African-American—that’s over 150,000 people.

It’s not entirely clear why African-Americans are at increased risk. Genetic and environmental factors, along with increased rates of diabetes and lack of access to health care, play a big role.

“African-Americans are six times more likely than Caucasians to develop hypertension-related kidney failure. I always stress the importance of controlling hypertension to my patients because even mild elevations in blood pressure are associated with significantly high risk of kidney failure particularly in African-Americans.”

- Dr. Ola Akinboboye, Associate Professor of Clinical Medicine at Cornell University and President of the Association of Black Cardiologists (ABC).

You are at increased risk for hypertension if you:

• Are over 45 years of age• Are overweight• Are African American• Have a family member with hypertension• Are not physically active• Eat a diet high in salt• Drink too much alcohol• Smoke

Lower Your Risk

The good news is that there are steps you can take to help prevent or control high blood pressure and protect your kidneys from permanent and progressive damage.

Maintain a Healthy Weight. Eating well and being physically active can help you maintain a healthy weight and reduce your risk for hypertension and kidney disease, as well as other conditions. If you are overweight, losing just a few pounds can make a big difference.

Eat Well. A healthy diet has a balance of fruits, vegetables, whole grains, dairy products, lean meats and beans. Even small changes like limiting salt (sodium) and fat can make a big difference in your health. Limit salt by not adding it to your food while cooking or eating, choosing fresh or frozen vegetables over canned, avoiding processed foods and limiting fast food and salty snacks. Limit fat in your diet by choosing lean meats or fish, baking, grilling or broiling your foods instead of frying them, and shopping for fat-free and low-fat dairy products, salad dressing and mayonnaise. Remember to also control your portion sizes and skip a second serving of food.

Be Physically Active. The Department of Health and Human Services’ Physical Activity Guidelines recommend that adults get 30 minutes of moderate-intensity physical activity five days a week (for children, 60 minutes per day is recommended). If that seems like too much, start slow and work your way up to that amount. Be sure to talk to your doctor about what activities are appropriate for you.

Take Medicines as Directed. Ask your doctor how to take any medicines he or she prescribes. Make sure to take the medicines just how your doctor tells you. This may mean taking some medicines, like blood pressure medicines, even when you feel fine. Follow the label directions for any medicines you take, including over-the-counter medications. Share with your doctor a list of all of your medicines (even supplements) to help make sure that you are not taking anything that may harm your kidneys.

Limit Alcohol. Limiting how much alcohol you drink can help you keep a healthy blood pressure. Drinking alcohol in large amounts can cause your blood pressure to rise. Have no more than two drinks per day if you’re a man and no more than one drink per day if you’re a woman.

Avoid Tobacco. Using tobacco (smoking or chewing) puts you more at risk for high blood pressure, kidney disease and many other health problems. Quitting tobacco can reduce your blood pressure and either prevent or slow the progression of kidney disease.

Get Tested

Knowing your risk for hypertension or kidney disease and taking steps to reduce that risk are very important, but getting tested is equally important in managing these conditions. Hypertension and kidney disease often have no symptoms, so the only way to know for sure is to be checked.

To test for high blood pressure, your doctor will use a gauge and a blood pressure cuff, which is placed around your arm and inflated. It’s painless and takes just a few minutes. A healthy blood pressure is 120/80 or less for most people.

A blood test for creatinine that allows your doctor to determine your eGFR (estimated glomerular filtration rate). A normal eGFR is 60 or more. A low eGFR number may suggest some loss of kidney function and requires further testing.

A urine test to see if your kidneys are leaking small amounts of albumin.

Talk to your healthcare provider to find out if these tests might be right for you. Once you’ve been tested, keep track of your results. No matter what your results are, talk to your doctor about what they mean and when you should be tested again, and the steps you can take to lower your risk.